Wednesday, January 30, 2013

So how did the cleanse go, you ask!?
*If you missed Whole Foods Cleanse part 1, you can check it out here.

Well, the first day I felt amazing. I was proud of myself for picking something that was do-able, and that I was going to stick with.

And then days 2, 3 and 4 came. Oh boy, were those rough! I had tons of headaches, felt hungry a good portion of the the time, and just generally not well.

There were very clear warnings that this would happen. I was even warned that I may feel like I had the flu as the process of detoxifying our bodies can be like that.

Thankfully it never got that bad. But let me tell you, those days weren't that great!

Come on, thinly slicing up zucchini, topping it with tomatoes, onions and garlic, and calling it spaghetti is JUST.NOT.SPAGHETTI. And I wanted spaghetti! Which is a little ironic, because other than mac-n-cheese, I could really do without any form of spaghetti.

But then from day 5 to 7 it got better. The first week was done, and I had stuck to it!

I had never juiced so many green veggies in my life...and LOVED it!! I had never found avacados to be the smoothies, creamiest, delicious treat in the entire world. And wow, what an amazing bedtime snack was blueberries and almond milk!

I may have even been heard saying "Wow, those blueberries and almond milk are like a milkshake!"...several times.

Yes, its true, I'm now one of "those girls" that used to drive me crazy! But really, after eating tons of leafy greens, your taste buds change quite a bit, and suddenly almond milk and blueberries are the best milkshake ever!

OK, well, definitely not better than a chocolate moose tracks milkshake, but that's what got me here in the first place!

So back to the cleanse.

The second week was pretty easy overall. Yes, there were times that I wanted some chicken. There were times (ok, many times!) where I just wanted a glass of red wine. And daily, there were the times that I so desperately missed my morning cup of coffee and the experience that it lends me (decaf herbal tea is SO not the same!).

But 2 weeks came and went. And not one single morsel of gluten, dairy, caffeine, alcohol, animal products, refined sugar, or sweet fruits passed my lips.

In the process I lost 7 pounds, and a total of almost 5 inches (between my hips, thighs, stomach and chest) Unfortunately most of the evidence of this is found in my now-too-big bras, but hey, at least it's a start!

And now, it's been about 2 weeks since we officially completed the cleanse. I have had FAR less headaches, and when I do get them they are much less severe (even despite working so many night shifts lately, which was when they really would creep up on me!). I feel lighter, cleaner, and overall more healthy. And what's even better is I feel like this is a lifestyle and eating style that I can sustain.

The plan is to start to re-introduce animal products, mostly shrimp, salmon, chicken, and lean ground turkey back into my diet. But no longer do I feel the need to eat it every day! I am still making a green juice every morning because it makes me feel amazing afterwards. And I still look forward to the few nights when avacado in some form is on the menu!

The cleanse opened my eyes to a ton of greens that I never even knew I would enjoy (mostly in juice form), like swiss chard, kale, collard greens, and mustard greens. I inadvertently bought the last 2 on accident and found they worked just as well in a green juice (what in the world do all these plants look exactly alike for!).

And we are now following the 90/10 rule, which basically means that 90% of the time during the week my meals are healthy. Many are vegetarian, vegan or raw. The other 10% of the time, I can pick my pleasure.

What that really boils down to is 2 meals a week, Jon and I enjoy a nice juicy cheeseburger, or a slice of turtle cheesecake, or a glass of wine with dinner, or a sausage, mushroom and cheese pizza. And because it's just 2 meals, I don't have to feel guilty.

So if you're looking for a cleanse, let me know and I'll give the the link. And certainly, if you have more specific questions about what foods to choose, or what recipes I found to be better than others, hit me up in the comments section and I'll get back to you.

I have to say, this cleanse gave me the jump start that I needed to eat right and get back on track. I've been there before, but had swayed a little too far off the beaten path to get there completely on my own. And now that I'm back, there's no place I'd rather be!

Monday, January 28, 2013

By the title, you may be wondering "What in the world does a Whole Foods Cleanse have to do with nursing, in any form?" Well, that's a great question. And directly, I guess the answer is nothing. But indirectly, oh it has everything to do with nursing.

At the end of 2012, I was getting horrible headaches, feeling sluggish, and weighed a good 15 pounds more than my body likes to handle. I was tired when I woke up, and exhausted when it was time for bed again.

I was blaming my schedule. All that flip flopping from days to nights, and nights to days, can wreak havoc on the body.

But when I really thought about it, I also had to blame my food choices and the laziness that crept in and took the place of work-outs. Because lets be honest, a flip-flopped schedule doesn't just do all that on its own.

As an APN I think that it is important to not only take care of others, but truly take care of yourself. Which is something most nurses don't do well. And health, along with weight and food issues are just some of those things that can get pushed to the wayside.

When you're trying to get through a 10, 12, or 16 hour shift in which you get to suck down water once, and shove whatever food is in your face while standing right outside the patient doorway, there's not much thought to, "hmm, should I go downstairs and prepare a nice healthy salad, or just shove a bunch of those mini-cupcakes that are right across the hall from me at the nurses station!?" Cupcakes win every time.

Until walking across the hallway to get those cupcakes becomes harder because the strain on your knees is more than before, and oh my, am I actually getting out of breath??? comes into the picture.

So while I had some time away at my parents over the New Years holiday, I researched different cleanses. I knew that I wanted something drastic. Something that would produce results, and give me the boost to continue leading a healthy lifestyle.

But I also knew that I wanted something that would be sustainable. And the various fasts, juice cleanses and other gimmicks out there were not for me. Not let me eat for more than 6 or 7 hours, and I turn into someone...something...not pretty! So fasts were out! And I knew that drinking 3 juices a day for 5-7 days would produce results, but I would be starving, and probably go way overboard with chocolate, coffee, and wine once it was over. So that was out too.

And then I found it. A whole food cleanse that allows you to eat real, solid food, as many times a day as you want, all while cleansing and detoxifying the body.

For 14 days I cut out all gluten, dairy, caffeine, alcohol, animal products, refined sugar, and "sweet fruits."

What this left me with:
-any and every vegetable I ever wanted including sweet potatoes, yams, spaghetti squash, and butternut squash, but with an emphasis on eating as much greens as humanely possible!
-quinoa and brown rice
-apples, pears, and berries
-nut butters and nut milk (my preference was for almond butter and almond milk- the all natural, unsweetened kind)
-avacado (my saving grace of the 2 weeks!)

Our fridge has been overtaken with fruits and veggies...and this is towards the end of our shopping week!

So the cleanse is behind me, and the maintenance (and continued fat loss for me) is before me. At least until we go on a warm, sunny vacation at the end of February! Stay tuned for Cleanse Part 2 where I will tell ya just how the cleansing process went.

Friday, January 25, 2013

I don't know what it has been about the past 2 months, but we have had an exorbitant amount of deaths. Working in the PICU it can be said that death comes with the territory. And I certainly get that, but there have never been 2 months like this in the last 8 years that I've been at this hospital.

One day in November, we had 3 deaths. 3 different kids died in one day...ONE DAY!

Never, ever, have I done compressions on two children in one day, and both did not survive.

The third death that day was a beautiful teenager who I had the privilege of taking care of since July who had cancer. She was probably my favorite patient that I've taken care of since becoming an APN.

I admitted her over the summer when we thought she was going to die. And yet she didn't, for another five months. She had five months to live out a few last dreams and wishes while in the hospital. She Skyped with Enrique Iglesias, got his cell number, and even got a through-the-computer kiss!

We had a spa day full with nail painting, boa wearing, and facial hair removal (which was almost comical because she truly didn't have much hair...anywhere...because of the chemo!) But she wanted what little hair was above her lip off, and off it went!

After a few dance parties in which she taught me the "booty tooch" (I am not cool enough to know if that's the correct spelling...let's just say that's probably how my rendition of the dance went as well!), room decorating, pumpkin painting, and celebrating the holidays that came and went, it was finally her time. She died so peacefully, with only her mom, her dad, myself and an attending physician in the room (so that we could adequately titrate her pain medications while titrating down her respiratory support).

As if this horrible, death-filled day in November wasn't enough, the weeks to follow were filled with much in the same. 5 deaths in one week. 2 deaths a week later. 3 after that. They just keep coming. Or I guess going, depending on how you look at it.

In the weeks before and after all of those, I have lost count. Lost count of the times I've had to have horrible conversations with parents. Lost count of the compressions that were done. Lost count of tears I've seen shed. Lost count of all the little ones we've lost.

And it always amazes me that not one death is remotely similar to another. Each death of a child brings together a different family. Each patient has a different story. Each mother, each father has a different way of coping. Each sibling has to process it in a way that is to the best of their ability depending on their age.

And yet each death rings hard and true to each and every PICU nurse practitioner, bedside nurse, physician, respiratory therapist and nursing assistant. Not one death goes by that any one of the above is able to just shake it off as soon as Time of Death is pronounced.

There needs to be a time of reflection. A time of thinking of whether or not something else could be done. Or, in the cases of children who are DNR, could we have done anything else to make the patient and his or her family more comfortable.

More times than not, the answer is no. Almost every time the answer is no.

No, we could not have offered the patient any other medical treatment that would have saved their life. No, we could not have made the patient any more comfortable because their passing so was quiet, so peaceful, with almost a beauty in it. No, we acted to the best of our ability throughout the entire patient stay.

And yet, despite the answer being "No," there is some dissatisfaction in that. As if we could transform ourselves into magicians and magically take all of the pain away. From the patient, from the sobbing mother, from the father sitting quietly in the corner not able to fathom how he can be the cornerstone of the family while processing the horrible event.

But we are not magicians. We are people. And we certainly cannot grasp the full circle of life and death until is stares us in the face. And in the case of the last couple of months, sometimes we are faced with it more times than we would like to mention.

But one thing that I continually come away with, is life is precious. It is a gift. It is something not to be taken for granted. One day you can be healthy, I can be healthy, and the next we are not.

It is with this lesson that I want to change how I spend my time, my life. I want to be surrounded by family and best friends. I want to have people into my home and make memories. I want to go on vacations with family, and friends, and build memories that will last a lifetime, however long or short it may be.

I want to enjoy the long days of summer not by drowning myself with work, but enjoying a sunset stroll around the block, grilling and enjoying an ice cold drink on our balcony, and being active by playing the sports I love. And while it's cold (oh so unbearably cold here!) I want to relish in the cozy moments of days off, and the nights I get home at a reasonable time. Enjoy cozying up to my man with a big fluffy blanket, drinking that hot cocoa, and watching those movies that make us laugh!

Just relishing in life. Enjoying the moments that count. And realizing that all of it could end in a moment. It is a reality that the parents of my patients have had to come too far to early over the past few months. It is a reality that these patients have gone through. And it is a reality that has made a profound impact on me. I hope that it is able to impact you as well.

Friday, January 18, 2013

So after my 6 week hiatus, I realized that I had more page views while I was gone than prior to me leaving. Which was a little curious! Guess you guys like me gone, better than writing??

Hopefully not! But, I did find out the reason...at least what I'm attributing to the reason.

I was recognized as one of the top 30 nursing blogs in 2012! There were 6 blogs dedicated to APN blogs, and mine was one of them!

So thank you very much Best Masters in Nursing website.

And for you nurses and nurse practitioners, if you want a few more blogs to read, I'm sure the other recommendations are great (although i haven't had a chance to look through them yet). Once I do, I'll add the ones I loved to my side bar.

I'm working this weekend (day shift, thankfully!) and so I have today off. I generally try to take off the Friday and Monday surrounding the weekend so it doesn't seem as bad.

But tonight is date night with the man, although no eating out for us. We're on the tail end (day 12/14) of a whole foods cleanse. I definitely feel healthier, cleaner, and oh so ready for a good juicy burger : ) But in the future I will just pile that burger with tons of fresh, crisp vegetables! Love when lessons can be learned!

What are you doing this weekend?? Or if you have to work, anything fun planned for tonight?

Saturday, January 12, 2013

I've gotten a good slew of questions lately (mostly in my 6 week absence...sorry about that!), so I thought I'd do a version 2 of questions answered. If you missed the first Questions Answered, you can find them HERE.

So today I answer questions from what you always (never?) wanted to know about being an APN, the process of going through grad school, and poop. Yes, you read that correctly, poop!

So here goes:

1.) What school did you go to? What degree did you graduate with?

A: I went to Rush University in Chicago, mostly because you can do it completely online. I'm all for "going to school" in my PJs, sitting on my couch while drinking some hot coffee. As a bonus, if you are out of state, they will help to coordinate clinical experiences where you live. The program was great (not that I have anything to compare it to) and I thought helped to prepare me as much as school could for the real APN world.
As far as my degree, I went through the Acute Care Pediatric Nurse Practitioner program. This provided me a much more specific and hospital related education which was exactly what I wanted. I had one quarter spent in a primary care setting (100 hours) which I absolutely loved because of the doctor that trained me and the amazing practice she had, but the remaining 600 clinical hours were spent with various services in the inpatient setting.

2.) How long did school take you? Did you work full time or part time while going to undergrad and grad school?

A: I did the BSN for undergrad so that took 4 years. I went to school full time and worked part time my last year(only about 12-20 hours each week...mostly on the 12 hour side). The first 3 years I only got a job in the summer full time, that way I didn't have to work during school.

For grad school, I did school part time for the first two years while working full time. The last year of grad school there was no part time option, so I continued to work full time and did school/clinicals full time. Let me tell you if you have the option to cut back work hours DO SO!!!! I had no life. My husband and I hardly saw each other. And when we did, our dates were spent as what we lovingly called "Couch Dates" that consisted of us watching a move. Sounds great right...not- it was more like him watching the movie while I had the computer on my lap doing school work : ( There was no hand holding or cuddling involved. Not fun!

3.) How long should I wait until I go back to grad school?
A: Hmm, this is a great question. I think this answer is different for everyone based on their interests, what degree they are wanting to pursue, and where you are at in life. I was a bedside nurse in the PICU for 7 years before I got my first APN job. I think that this was a perfect amount of time for transition, if not a little on the "soonish" side.
I would definitely not recommend going straight from undergrad to grad school. There is something to be said about having that bedside experience. It will make you a much, MUCH better APN. That being said, you have to figure out the timing for yourself. I've seen a few girls go back to school after a year or 2, and while I thought that was way too soon and they weren't truly developed as much as they could have been as a nurse, they felt fine about it. And I've seen a handful of women go back once they were in their late 30's and 40's and their kids were older and in school full time, and they thrived.
So really, it depends on where you are in life, and what you want out of your job. Certainly there more experience you have as a bedside nurse, the better set up you will be going into your job as an APN.

4.) At what point did you realize you wanted to go into Pediatrics?

A: I always knew that I wanted to work with kids. At least I think I did...it's all that I can remember wanting to do! In high school I had the opportunity to take a health professions class that allowed me to go to the community hospital for 2 hours several times a week and essentially job shadow every possible job within the hospital. From physicians, to surgeons, to nurses, to chaplains, to lab techs, to the cleaning crew, I shadowed them all. It was then that I decided I absolutely wanted to be a nurse!
Then, once I was in college, I knew that I loved kids. I was most excited about my peds rotation, but also equally excited for the Labor and Delivery/Mother Baby rotation. And I loved both. Well, I really loved peds, mostly loved L & D and only kinda loved mother/baby.
But then came time for summer internship right after my junior year in undergrad. I applied for the Pediatrics with Labor and Delivery as a back up. Well, I didn't get the Peds. And I actually didn't truly get the L & D either. They put me in Mother/Baby with a few days in L & D. And let me tell you, that was the best summer job I'd ever had! Not that it was hard to beat washing old men's butts while working the evening shift (3 pm- 11pm) the summer before!
But once it was all said and done, I got a PICU nursing assistant job at a children's hospital near school, and fell in love. So once I graduated I knew that pediatrics was for me. And more specifically, the PICU was for me!

*For those of you still in school and trying to decide what you want to go into, just give it time. Clinicals are an incredible time to really figure out what you like and what you don't. That being said, just because you don't have a great clinical in one area don't completely rule it out if it is something you think you are passionate about. It may just be that that particular hospital is not a great fit for you. If you truly are interested, go to another hospital and ask to do some job shadowing to help make your decision.

5.) Do you see yourself working in the hospital setting long term?

A: Yes! I can't imagine working outside of the PICU. That being said, it's not necessarily what I'm going to do the rest of my life. If there were PICU positions out there that did not require nights then I would probably stick with it, but in the age of APNs getting more and more autonomy in practice, it is now most popular for APNs to provide 24/7 coverage. BUT- regardless of what I do, I certainly can't see myself working in a general pediatric clinic. The primary reason that I went back to school to get my acute care certificate as opposed to the primary care certificate was because I didn't want to solely limit myself to the outpatient setting.

6.) You talked a lot about poop early on in your blog, and not as much lately. Does that mean as an APN you don't deal with poop anymore?

A: Oh yes, I did talk a lot about poop didn't I. If you're new and haven't made it back that far, you can read about it here, here, and here. Oh there are many others, I just didn't have the time to peruse through them all and link them up.
But back to the topic. I must say, being an APN is much less poopy. I think I have changed all of 3 diapers in my 7 months of being an APN. And none of them were catstrophies. Most were just helping the nurse because I was there and had nothing better to do.
I will say, the other night at work a teenager with Duchenne's Muscular Dystrophy who was wearing a diaper told me he needed changed. There was a big piece of me that wanted to say, OK let me go get help and I'll be right back. But then I remembered that there were 12 other patients that needed to be seen by me, and this could take awhile. So I said "OK, I'll go get your nurse and let him know." Which just felt weird. Not that I'm missing changing teenager poopy diapers, but I'm still getting used to pushing those things off to the bedside nurses. Afterall, I was there just 7 months ago!

OK, that wraps up a very lengthy Questions Answered part 2. Keep the questions coming, and I'll keep answering them. I love having nursing students and grad students read my blog because I know that there were several blogs out there that helped me as I was going through grad school, and this is my way to give back.

So what did you learn today?
1.) Rush University lets you go through all of school in your PJs while sitting on your comfy couch...does school get any better than that!?
2.) Be a bedside nurse for a good long time and enjoy it before becoming and APN...a "good long time" should be defined by you.
3.) Clinicals are a great way to figure out what type of nurse you want to be...but don't let clinicals be the end all, be all. After all, I never had a clinical in PICU and here I am today, absolutely loving it!
4.) There's no place like home...especially if your home is in the PICU, and not a clinic setting!
5.) Being an APN is a lot less sh...I mean, poopy than being a bedside nurse. Or at least you deal with a lot less poop....in the most literal sense possible, because trust me you still deal with a ton of "people" poop!

Wednesday, January 9, 2013

I come back after almost 6 weeks off to several new followers and subscribers...so thank you and welcome. Sorry for the lack of blogging, probably right after you subscribed!! And if you asked questions via email or in my comments, I promise to address those very soon!

But now I'm back! I've been on a blogging hiatus not because I've not been working and didn't have material to talk about, but mostly because work was working me in December, and it's taken me the beginning of January to work things out with a glorious week off. Wow, lot's of "work" in that sentence.

Part of my lack of blogging about work was because the end of November and all of December was just crazy. Our 40 bed PICU was jammed full with sick kids. We had many deaths...far more deaths in a 5 week period than we have ever experienced in my 8 years of working there. And to top all that, we are short a few (ok, more like 10!) APNs. And our fellows that should be providing coverage in the PICU 24/7 are having to provide cross-coverage about 50% of night shifts in the Cardiac ICU leaving a bigger staff deficit.

So that leaves a full unit of very sick kids, with overworked (and underpaid depending on what practice you are speaking of!) APNs and doctors.

This translates to a highly stressful and more emotional month than I've had in a long time.

But it's a new year which to me a new start with work. I had almost 2 full weeks off, was able to get out of town to visit my family, and just recharge. And boy did I need it.

It was ten days full of stretch pants and comfy sweatshirt wearing, only taken off to go for a refreshing walk or jog, lots of great comfort food (to balance out all of those workouts of course!), no make-up whatsoever, game playing, movie watching, and lots of family fun! That really helps putting a new year into perspective rather than just rolling right into the new year trudging through work.

So I came back in town, and went back to work Monday night...way to just jump right back into the swing of things with going back to 16 hour nights!

I must say, while we still are full with high acuity, there was a calm over me that I did not have in December. There was a patience that I had that certainly was not there last month. And while it was a busy night and I had a horrific headache, there was a little voice in my head saying "You can do this. You will get through this night. Everything will be ok!"

And it was ok. The night was over soon enough, and I was able to go home and get some amazing sleep during the day (which usually doesn't happen for me).

So I'm grateful for New Starts in the New Year. No, the PICU is still the PICU. And yes, we still are crazy full with crazy sick kids and just plain crazy parents. But the new year tends to bring a fresh perspective and outlook that has helped me this year.

With that calm, I am back to blogging. And once again, to my new readers, welcome. To my old readers thanks for sticking with me.

I hope that this new year has given you a fresh perspective, more patience, and a new outlook that will make you more successful in your job, and more happy in your life in general!

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About Me

I am a new PICU Nurse Practitioner working in the same PICU where I had previously been a bedside nurse for 7 years. This blog is a way for me to document the many fun, memorable, crazy things that come out of taking care of PICU patients. And occasionally I like to throw in some personal documentation of other things that I love- cooking meals with my man, drinking a great glass of wine, decorating my home, thrift shopping, high heel wearing, and traveling. This is my adventure...thank you for stopping in to enjoy the ride!
DISCLAIMER: Any stories in this blog are written to protect patient confidentiality and not violate HIPPA. Names, ages etc. have been changed. If you think that I'm talking about you, I'm not...there are tons of other patients out there that have the exact diagnosis as you, and the same loving/crazy/wonderful/stressed out/amazing/wacko parents to back them up! : )